Clinical results with the dual chamber cardioverter defibrillator phylax av and tachos dr-msv. efficacy of smart 1 and 2 discrimination algorhythm

Merkely, Béla; Bielik, H.; Zima, Endre; Vágó, Hajnalka; Gellér, László

doi:10.1016/eupace/2.supplement_1.a47-a

Cited by 1 publication

(3 citation statements)

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“…The analysis of data retrieved from published clinical studies, multicenter registries, and reports by the manufacturers summarizing the results of multicenter market release studies 7–14 revealed major differences in the specificity for correct classification of supraventricular tachyarrhythmias. This clinical specificity shows an inverse correlation to the number of patients, total number of arrhythmias, and number of supraventricular tachyarrhythmias included in these studies.…”

Section: Discussionmentioning

confidence: 99%

“…A survey was conducted of all available sources providing data regarding the specificity of the five dual chamber ICD algorithms on the market at the time of the simulation (Table I). The data sources included published clinical studies, multicenter registries, and reports by the manufacturers summarizing the results of multicenter market release studies 7–14 . The specificity was correlated with data defining the size and determining the statistical power of these studies (i.e., number of patients included, total number of episodes, and number of supraventricular tachyarrhythmias recorded).…”

Section: Methodsmentioning

confidence: 99%

“…Despite the introduction of more advanced detection algorithms, a substantial number of patients are still receiving inappropriate therapy 3–6 . The specificity of ICDs (i.e., the correct classification of supraventricular tachyarrhythmias and the subsequent inhibition of therapy) is individually calculated for each algorithm from studies or registries mostly conducted by the manufacturers themselves in cooperation with clinical investigators 7–14 . However, many factors may influence the results.…”

Section: Introductionmentioning

confidence: 99%

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Comparison of the Specificity of Implantable Dual Chamber Defibrillator Detection Algorithms

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The aim of the study was to compare the specificity of dual chamber ICDs detection algorithms for correct classification of supraventricular tachyarrhythmias derived from clinical studies according to their size to detect an impact of sample size on the specificity. Furthermore, the study sought to compare the specificities of detection algorithms calculated from clinical data with the specificity calculated from simulations of tachyarrhythmias. A survey was conducted of all available sources providing data regarding the specificity of five dual chamber ICDs. The specificity was correlated with the number of patients included, number of episodes, and number of supraventricular tachyarrhythmias recorded. The simulation was performed using tachyarrhythmias recorded in the electrophysiology laboratory. The range of the number of patients included into the studies was 78-1,029, the range of the total number of episodes recorded was 362-5,788, and the range of the number of supraventricular tachyarrhythmias used for calculation of the specificity for correct detection of these arrhythmias was 100 (Biotronik) to 1662 (Medtronic). The specificity for correct detection of supraventricular tachyarrhythmias was 90% (Biotronik), 89% (ELA Medical), 89% (Guidant), 68% (Medtronic), and 76% (St. Jude Medical). There was an inverse correlation (r = -0.9, P = 0.037) between the specificity for correct classification of supraventricular tachyarrhythmias and the number of patients. The specificity for correct detection of supraventricular tachyarrhythmias calculated from the simulation after correction for the clinical prevalence of the simulated tachyarrhythmias was 95% (Biotronik), 99% (ELA Medical), 94% (Guidant), 93% (Medtronic), and 92% (St. Jude Medical). In conclusion, the specificity of ICD detection algorithms calculated from clinical studies or registries may depend on the number of patients studied. Therefore, a direct comparison between different detection algorithms based on clinical data is difficult. In contrast, simulation of supraventricular tachyarrhythmias using a uniform database may be a better tool for direct comparison of the specificity of ICD detection algorithms.

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%